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Redo gracilis interposition for complex perineal fistulas

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Abstract

Background

Rectovaginal, pouch-vaginal, and recto-urethral fistulas are very challenging to treat. Gracilis muscle interposition was shown be an effective treatment for these complex fistulas. The aim of this study was to investigate the feasibility and outcomes of redo gracilis interposition for persistent and recurrent complex perineal fistulas.

Methods

A retrospective analysis of all patients who had redo gracilis muscle interposition for complex perineal fistulas at our institution from 1995 to 2019 was performed.

Results

Nine patients (5 males, mean age 55 years) were included for analysis. The types of fistulas were recto-urethral (n = 5), rectovaginal (n = 2) and pouch-vaginal (n = 2). The success rate was 56% with 5 patients achieving complete healing of the fistula. Only 1 patient (11%) experienced a postoperative complication.

Conclusions

Redo gracilis muscle interposition is feasible and safe with promising resultsin healing of complex perineal fistula.

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Authors and Affiliations

  1. Department of Colorectal Surgery, Cleveland Clinic Florida, 2950 Cleveland Clinic Blvd., Weston, FL, 33331, USA

    H. Gilshtein, V. Strassman & S. D. Wexner

Authors
  1. H. Gilshtein
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  2. V. Strassman
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  3. S. D. Wexner
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Corresponding author

Correspondence to S. D. Wexner.

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The authors declare that they have no conflict of interest.

Ethical approval

This study was approved by our institutional review board.

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All patients gave informed consent prior to all surgeries.

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Gilshtein, H., Strassman, V. & Wexner, S.D. Redo gracilis interposition for complex perineal fistulas. Tech Coloproctol 24, 475–478 (2020). https://doi.org/10.1007/s10151-020-02185-x

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  • DOI: https://doi.org/10.1007/s10151-020-02185-x

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